Healthy Living in the North

Breastfeeding: a cultural approach can make all the difference

In 1977, Buffy Sainte-Marie, a Plains Cree woman from the Piapot reserve, appeared on Sesame Street explaining breastfeeding to Big Bird as she breastfed her son, Dakota “Cody” Starblanket Wolfchild. This was the first time breastfeeding had been shown on a major television station. At the time, this was quite radical. Mothers had been taught since the early 1900s that they should rely on experts for advice and they were recommending formula. In 1977, to push back against “experts” to promote breastfeeding was groundbreaking.

Creating cultural connection through breastfeeding
Since then, we’ve learnt a lot about about the importance of culture in the health and well-being of Indigenous peoples in Canada, and we’re beginning to understand the role breastfeeding plays in connecting to culture. Breastfeeding creates a strong physical bond between mothers and babies that carries the cultural values and beliefs of the mother to the child, connecting the child to the past and future. Research shows that Indigenous moms who have strong cultural and spiritual resources to turn to, take up and keep up breastfeeding, at rates better than the overall population of nursing mothers. For example, Rhodes (2008) found Indigenous women most connected to traditional ways were sixteen times more likely to breastfeed.

The valuable contributions culture can bring to breastfeeding and health has been weakened by colonization. Widespread disruption of home, family and cultural connections has harmed generations of Indigenous people in Canada through Residential Schools, Indian Hospitals, and other high level policies.The widespread disruption caused by colonization meant the loss of mothers, aunties, and grandmothers who were crucial to the success of young mothers’ breastfeeding.

Breastfeeding & child health
Not breastfeeding has a high price.The report on child health released by Northern Health’s Chief Medical Health officer last year, showed rates of early childhood dental caries/cavities (ECC) in northern BC five times the provincial average, and children living in northern regions undergo surgery for dental issues at three times the provincial average. The risk for early childhood caries is greater in some Indigenous communites with higher rates of bottle feeding and, in these cases, a cultural approach to breastfeeding is an effective protective factor against ECC.(See: Cidro et al. Breast feeding practices as cultural interventions for early childhood caries in Cree communities, 2015.)

Creating healthy cultural practice
Supporting Indigenous mothers will require extra care from health care providers. Understanding the importance of culture in supporting breastfeeding can reduce the specific and systemic barriers that exist for Indigenous mothers. Many mothers are hungry for the connection between themselves, their children, and their culture. Many loved ones and community members may also want to understand and reclaim their roles in supporting breastfeeding as a cultural practice.

You could be an important bridge for reclaiming these connections. Questions to ask a breastfeeding mother could include:

  • Would you like an Elder or trusted loved one to be part of the visit?
  • Are there any cultural and traditional practices that would be helpful for you?
  • Is there anything special that would help you in breastfeeding?

Breastfeeding, supported as a healthy cultural practice, promises much for improving and restoring health and well-being within Indigenous communities. Providing culturally safe services is a call to action: what can we do to promote breastfeeding in a culturally safe way for the Indigenous mothers in our care? What is it you can do?

Overall,  being aware of the underlying impacts of past negative experiences and how they’ve influenced Indigenous people’s encounters with the health care system is most important. If you can do this, you will send the message that you know about and are ready to respect the cultural bonds of breastfeeding.

We know that discussion of sensitive topics like this may cause distress. Please ensure you or the people you are working with have access to the supports you need.

Want to learn more? Check out:

 

Citations:

  • Rhodes et al. American Indian Breastfeeding Attitudes and Practices in Minnesota Maternal and Child Health Journal July 2008, Volume 12, Supplement 1, pp 46–54
  • Buffy Sainte-Marie started CradleBoard a site to improve curriculum. You can access this interactive web site at http://www.cradleboard.org/2000/mission.html though not all links work.
  • Cidrio, et al. feeding practices as cultural interventions for early childhood caries in Cree communities https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409764/
Theresa Healy

About Theresa Healy

Theresa is the regional manager for healthy community development with Northern Health’s population health team and is passionate about the capacity of individuals, families and communities across northern B.C. to be partners in health and wellness. As part of her own health and wellness plan, she has taken up running and, more recently, weight lifting. She is also a “new-bee” bee-keeper and a devoted new grandmother. Theresa is an avid historian, writer and researcher who also holds an adjunct appointment at UNBC that allows her to pursue her other passionate love – teaching.

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Feeding our babies: at what age can we start offering solid foods?

The question

As a mom, I know it can be hard to get straight answers to parenting questions. Websites and discussion boards offer so many conflicting opinions (right?). Even professional recommendations sometime vary. This can be confusing… and frustrating!

baby eating solid foods in high chair

At six months, my daughter let us know she was ready for solids. Here she is eating little bits of soft stew meat as her first food!

As a dietitian, I also know people have a LOT of questions about feeding their babies. Here’s an important one: “When is the ‘right’ time to start offering solid food?”

The recommendation

Northern Health supports the following recommendations from World Health Organization, Health Canada, Canadian Pediatric Society, Dietitians of Canada, Breastfeeding Committee for Canada, and Perinatal Services BC:

  • Infants are exclusively breastfed for the first six months of life
  • With continued breastfeeding, complementary solid foods and other fluids are introduced around the age of six months of life
  • Continued breastfeeding is recommended for up to two years and beyond

Well, now that’s a mouthful! Let’s simplify that:

“Breastmilk is the only food a baby needs for the first six months. After that, keep breastfeeding and offer nutritious foods, too.”

The details

Since there are some variations in when babies are ready to eat food, we see the language of starting foods at about six months of age. Some babies will be ready for food a few weeks earlier than six months, some a few weeks later. Your baby will give you signs, not just that they are interested in food, but also that they are developmentally ready. Your baby may be ready for solids if they can:

  • Sit up, unsupported
  • Open their mouth for food
  • Turn their head when they are full

Our daughter let us know when she was ready, which, for her, was just before six months (I have proud mama pictures of her eating little bits of soft stew meat as her first food. So cute!).

More questions

“Don’t some people say, ‘Food before one is just for fun’?”

Red flag! This phrase is concerning because we know how important food is for babies, starting at about six months. One big reason is the increased need for iron at this age. Other reasons include involving babies in family meals and supporting the development of their eating and food acceptance skills.

“What about children at risk for food allergies?”

You may have seen some media stories about the prevention of peanut allergy, where “four-to-six months” is sometimes mentioned. To clarify, the majority of families (98-99%) can introduce peanuts, at home, when baby is about six months old (for more information about safely introducing peanuts and other common food allergens, see Reducing Risk of Food Allergy in your Baby). For a baby with egg allergy or severe eczema (this is not common), their doctor can help make an individualized plan that may involve testing for peanut allergy before introducing peanut-containing foods.

Want up-to-date information on first foods for babies? Check out the following resources:

Lise Luppens

About Lise Luppens

Lise started her career as a dietitian with Northern Health in 2004 when she moved to Terrace “for a year.” More than 10 years later, she is now part of the regional population health registered dietitian team and she continues to love living, working and playing in B.C.’s northwest. Lise enjoys playing outside with her husband and friends and you might find her skiing, biking or kiting. She’s passionate about local food, keeps a garden, enjoys local community-supported agriculture (CSA) and farmers market goodies, and carries out food preservation projects.

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Are you a SmartMom?

Becoming a “mama” was the best thing to ever happen to me! As a nurse working in public health, I thought I had all of the knowledge, tools, and skills I needed to be a “smart” mom. I honestly thought it was going to be easy! During my pregnancy, I chose not to attend traditional prenatal classes due to transportation issues. Instead, I sought pregnancy, breastfeeding, labour, and delivery information from a variety of other credible sources including books, videos, websites, and our birth doula. Although I felt prepared, I was lacking a stronger support system that I did not even realize I needed.

pregnant women holding cell phone

SmartMom is a free text-based service that guides soon-to-be mothers through every week of pregnancy. Texts are tailored to their due dates and information is from trusted health sources.

When I returned to work after my maternity leave, I learned about a new prenatal education program that was coming to the north: SmartMom. SmartMom is a prenatal education program that texts evidence-based pregnancy information to women via phone or computer. It is the first program of its kind in Canada! As soon as I learned about SmartMom, I realized that this program would have been so helpful for me and my spouse during my pregnancy!

As my own experience suggests, nowadays, women are choosing to get their prenatal information in a variety of unique ways above and beyond traditional prenatal classes. The texts from SmartMom are meant to complement the prenatal education women are already accessing in their communities through group prenatal classes, one-on-one sessions with a health care provider, or their own research of credible sources. The beautiful thing about SmartMom is that it delivers text messages tailored to a woman’s stage in pregnancy.

How it works

sample of text messages

SmartMom will text you information tailored to your due date via cell phone or computer. To enroll, text “SmartMom” to 12323 or visit www.smartmomcanada.ca

Women sign up to receive text messages with information that can be helpful when discussing concerns with their health care providers, as well as supporting them in making choices about their health. In addition to receiving supportive prenatal information, women also have the option of subscribing to supplemental messages, including topics of specific interest to them: alcohol use in pregnancy, nutrition and exercise, substance and tobacco use, exposure to violence, being an older mom, and information about labouring after a caesarean section. These supplemental streams of messaging can assist women in making choices specific to their health and their pregnancy. The ultimate goal of SmartMom is to have healthier mommies, babies, and families!

SmartMom is available now! There are three ways to sign up:
• Contact a health care provider for information
• Text “SmartMom” to 12323
• Visit www.smartmomcanada.ca

As I came to realize, becoming a”smart” mom is a learning process; it takes time to learn how to be the healthiest version of yourself for your children and your family. A program like SmartMom can really help a new mom increase her knowledge and prepare for the wonderful journey that lies ahead!

Randi Parsons

About Randi Parsons

Randi has lived in northern BC since 2010 after graduating from the University of Alberta with her Bachelor of Science in Nursing. Since her graduation, Randi has held different nursing positions with a focus in maternal-child health. Her career as a nurse started on Pediatrics in Prince George before transitioning into Public Health Nursing in the Omineca area. For 5 years, Randi worked as a generalist Public Health Nurse, finding her passion in perinatal wellness, early child development and community collaboration. With her husband, daughter and two Chihuahuas, Randi lives in Fraser Lake, currently working as the Regional Nursing Lead for Maternal, Infant, Child, Youth with Public Health Practice. When she is not nursing, Randi enjoys crafting, practicing yoga, learning to garden and being a mom! She is passionate about raising awareness for mental health and advocating for women, children and families.

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Beware the noisy toy

Baby with toy

Do you know how loud your kids’ toys are? A few simple steps can help protect their hearing health!

I have seen many an adult with hearing loss due to excessive noise exposure. In my current role as a pediatric audiologist, I am more likely to see hearing problems due to an ear infection than to noise damage. That doesn’t mean it’s not possible, though.

The Canada Consumer Product Safety Act has a section on Toy Regulations. In it, they suggest that: “A toy must not make or emit noise of more than 100 decibels (dB) when measured at the distance that the toy would ordinarily be from the ear of the child who is using it.” One hundred decibels, though, is pretty darn loud!

Worksafe BC counsels, as do many safe workplace organizations, that at noise levels of 85 dB, an employer needs to provide proper hearing protection for their staff. Audiologists in both Canada and the US would agree this should also apply to toys. Granted, children may not play with that same toy for 8 hours (the length of an average workday); it’s more than likely that after about 10 minutes their parent tends to direct them to another, quieter, activity. But even these short playtimes with loud toys can be unsafe: Worksafe BC also counsels that workers can only be exposed to 100 dB for a period of 15 minutes before that noise becomes hazardous to hearing health.

Toy manufacturers are not required to specify the decibel output of their product, so how would a parent or well-meaning relative know? To put it into perspective: a gas-powered lawn mower is about 100 dB. So is a subway train entering the station. However, in neither case is the listener’s head as close to the sound as a child’s ear can be to a toy, or a teenager’s to an iPod. It stands to reason: the closer a sound is to our ears, the louder it is.

As parents don’t usually have sound level meters in their homes, what can they do?

Here are a few pointers:

  • Try before you buy. Listen to the toy, keeping in mind how close children will hold it to their ears. If you find it uncomfortably loud, it’s too loud for your child.
  • Is there a volume limiter, off switch, or battery compartment? You can always shut it off or remove the batteries. In the case of an iPod, iPhone, and/or iPad, a parent can access the volume limiter, reduce it, and lock it. Your teen may not be impressed, but their hearing health is protected – at least from the iDevice.
  • Depending on the size of the toy, put clear tape over the speaker. It will still make noise, but not as loud. If you’re crafty enough, your child may not even realize it’s there.

Interested in more information?

The Sight & Hearing Association, based out of Minnesota, provides an Annual Noisy Toys List. They use 85 dB as their upper limit, and a list can be provided to anyone who requests it!

Laura Curran

About Laura Curran

An audiologist at the Terrace Health Unit, Laura was born and raised in Nova Scotia but has made the trek to Terrace twice in her career – most recently in 2014, as she found she missed the beauty of the area. She started out in private practice for a national hearing aid dispenser and then moved into research before finding her main passion: Clinical Pediatric Audiology. When not working, Laura enjoys crafting, quilting, and camping with her husband.

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Babies, solid foods, and allergies: What do you need to know?

Are you worried that your baby might develop a food allergy? I was. A baby is at higher risk of developing an allergy if they have a parent or sibling with a food allergy, eczema, asthma or hay fever, or if the baby has severe eczema. My husband had various nut allergies when he was young, many of which he outgrew, but he still has a strong reaction to Brazil nuts. Given my husband’s history, my daughter is at higher risk of developing a food allergy.

baby eating solids

Early introduction to common food allergens may help reduce the risk of children developing allergies.

You might be a bit nervous about introducing certain foods to your baby – I was! The foods most likely to be involved in food allergies are called “common food allergens.” They are:

  • Eggs
  • Milk and milk products
  • Peanuts
  • Seafood (fish, crustaceans, and shellfish)
  • Sesame
  • Soy
  • Tree nuts (almond, Brazil nuts, cashews, pistachios, etc.)
  • Wheat

As a dietitian, I have seen the advice on introducing common food allergens change – a lot! Years ago, it was thought best to wait to offer these foods until baby was a year old, or two years old, or even older. However, research over the past 10 years has shown us that there is no benefit to waiting that long. In fact, new research, especially research on peanuts, shows that earlier introduction may actually help to reduce risk of allergies. Wow!

What does this mean for feeding your baby? The most current research supports these guidelines:

  • Start offering solid foods when your baby is about six months old.
  • Offer foods high in iron twice per day; iron is very important for babies. Examples include well-cooked meat, poultry, and fish; cooked eggs, lentils, beans, chickpeas and tofu; and peanut, tree nut, and seed butters. For more ideas, see “Pumping iron: First foods for building strong babies”.
  • Don’t wait. You can offer common food allergens when baby is ready for solids, at around six months of age.
  • Worried about allergy risk? Introduce common food allergens one at a time (other foods do not need to be introduced one at a time). In the event of an allergic reaction, symptoms often appear within minutes of eating the food, but they can also occur hours later.
  • Worried that a food caused an allergic reaction? Stop offering that food and connect with your child’s doctor for a diagnosis. You can continue to offer other new foods to your baby, including other common food allergens.

When it was time to start our baby on solid foods, I was a little nervous about things like peanut butter. I made sure to offer these foods when my husband and I were both around, and I watched my daughter for signs of a reaction. Luckily, we have not yet seen any signs of allergy, and she has now been introduced a wide variety of common food allergens.

It was helpful to know where to go for help in case we had questions. Did you know that there is a Registered Dietitian at HealthLink BC who can support families who have concerns about food allergies? They are only a phone call away – just dial 8-1-1.

Looking for more information and support? HealthLink BC’s resource “Reducing Risk of Food Allergy in Your Baby” provides additional information on introducing common food allergens to infants.

Lise Luppens

About Lise Luppens

Lise started her career as a dietitian with Northern Health in 2004 when she moved to Terrace “for a year.” More than 10 years later, she is now part of the regional population health registered dietitian team and she continues to love living, working and playing in B.C.’s northwest. Lise enjoys playing outside with her husband and friends and you might find her skiing, biking or kiting. She’s passionate about local food, keeps a garden, enjoys local community-supported agriculture (CSA) and farmers market goodies, and carries out food preservation projects.

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Helping your child embrace the open cup

Caribou mascot in front of oral health poster

For a lifetime of healthy smiles, let your child drink from a lidless, regular cup.

Sippy cups are popular with parents and preschoolers alike. Many parents find comfort in knowing that there will be less mess with these spill-proof cups. They sure are handy for families on the go!

But did you know that drinking from an open cup, rather than a sippy cup, helps kids develop good tongue movements needed for speech? It may also encourage more communication and interaction, helping kids learn new sounds and words! There are also worries about dental health and nutrition if kids have regular access to sippy cups with drinks other than water. When kids carry around their sippy cups (as they often do) they tend to sip their drink over long periods of time, leading to cavities and ruined appetites.

So, how do families balance this information with the realities of everyday life? Adults play an important role in deciding what drinks to offer kids and the manner in which they are offered. Many parents find it helpful to try limiting the use of sippy cups for times when mess is an issue, like on your neighbour’s new white carpet! Or, try filling sippy cups with plain water rather than juice or milk to help prevent cavities. Whether it’s an open cup or a sippy cup, children do best with regular, sit-down meal and snacks and water in-between to satisfy thirst.

Here are some tips to help encourage the use of open cups:

  • Remove the valve on the sippy cup to help children learn to drink without sucking.
  • Use small cups that are easier for children to hold.
  • Bring home a new, special cup or let your child pick one out from the store.
  • Sit and eat with your child so they can see you drink from an open cup.
  • Avoid distractions such as toys, TV, or computers when eating or drinking to help your child focus on the task at hand.

With your example, and lots of chances to learn, children will master and enjoy drinking from an open cup in no time!

Emilia Moulechkova

About Emilia Moulechkova

Originally from the Lower Mainland, Emilia started her career with Northern Health as a dietetic intern in 2013. Since then, she has worked in a variety of roles as a Registered Dietitian with the population health team. In her current role, she supports schools across the north in their efforts to promote healthy eating. Emilia is passionate about food’s role in bringing people and communities together, and all the ways it can support physical, mental, and social health. Her overall philosophy on healthy eating can be summarized by this Ellyn Satter quote: “When the joy goes out of eating, nutrition suffers.” In her spare time, she loves exploring the beautiful northern outdoors by foot, skis, bike, or canoe!

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10 tips for talking to kids about tobacco

Family walking in woods.

Talk to your kids about tobacco!

You can make a difference!

1. Don’t assume kids will learn all they need to know to be tobacco free at school and that you don’t need to get involved. Parents can help their kids to avoid the use of tobacco.

2. Let them know how you feel about tobacco use and help them develop the skills to say no to tobacco.

3. Kids do listen. They may feel a need to rebel at first but they will value the message, especially coming from you.

4. Make an emotional appeal – telling them how hurt or disappointed you would be by their smoking or chewing will have more impact than reasoning with them about the health dangers.

5. Know that peer pressure is often used as an excuse for tobacco use – it may provide an opportunity to start, but kids continue to smoke or chew for individual reasons.

6. Be a good role model – if you do smoke or chew, explain that you know it’s wrong and ask them to help you quit. If you aren’t ready to quit, share the reasons why you started, how hard it’s been to quit, and how you don’t want them to struggle with the same addiction you have.

7. Encourage your children to never try tobacco. It may only take a few cigarettes to become addicted. Instead, encourage them to develop healthy lifestyles and avoid the use of tobacco.

8. Have extended family support to keep kids tobacco free – often older siblings or other relatives introduce them to smoking or chewing.

9. Don’t believe that smoking or chewing is safer than “something else” – most kids are at real and greater risk from tobacco use than from other dangers. Research shows smoking is a gateway to other drug use.

10. It’s never too late to intervene. Kids are flexible and they can change for the right reasons.


In this article, as in most public health messaging, “tobacco” is short for commercial tobacco products like cigarettes and chewing tobacco. Using these is highly addictive and is a leading cause of disease and premature death. However, Northern Health recognizes that natural tobacco has been an integral part of many Indigenous cultures in B.C. for thousands of years. Traditional uses of tobacco in ritual, ceremony, and prayer is entirely different from smoking or chewing commercial tobacco. Northern Health supports the cultural and ceremonial uses of tobacco and recognizes that the benefits of traditional uses can outweigh the potential harms.

Nancy Viney

About Nancy Viney

Nancy is a registered nurse working in Northern Health’s population health team. She often imagines a day when no one in northern British Columbia suffers from the harmful effects of tobacco. In her time off, she enjoys spending time with her family and friends, especially her two little grandchildren! Nancy also enjoys quilting, knitting, crocheting and many other home spun crafts.

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Orange Shirt Day

Two women dressed in orange

Marking Orange Shirt Day in Kitsumkalum.

I was honoured to be invited to Kitsumkalum’s Orange Shirt Day by Charlene Webb, the community health director. Although I got to wear a beautiful locally designed orange shirt, enjoy yummy orange food, and visit with many people, this event has a sad undertone.

What is Orange Shirt Day?

September 29th is Orange Shirt Day – a day of remembrance and recognition of residential school survivors and those who did not survive.

It is a day each year to acknowledge the harm done by the residential school system to children’s self-esteem and well-being and to remember that every child matters. Orange Shirt Day grew out of Phyllis’ story. In 1973, when she was 6 years old, Phyllis attended the Mission school. On her first day of school, her clothes (including a special, brand new, shiny orange shirt) were taken from her and replaced with a uniform. Orange Shirt Day is an annual opportunity to engage in a discussion on all aspects of the residential school system.

Residential schools

September is when children go back to school and it is therefore timely to remember the Indigenous children in Canada who were taken from their families and travelled long distances to attend residential schools. Instead of being nurtured and supported, many suffered emotional, physical, and sexual abuse there.

Residential schools are a dark part of Canadian history that make me very sad. As a 6th generation Canadian white woman with First Nations children, I have struggled with this part of Canada’s history. I first learned about residential schools when I was pregnant with my first child. I was devastated that such a thing could happen. As a parent, I cannot imagine a more heart wrenching and devastating experience than having my children forcibly removed and taken far away where I cannot protect them or care for them.

Woman wearing "Every Child Matters" shirt

Orange Shirt Day is a day each year to acknowledge the harm done by the residential school system to children’s self-esteem and well-being and to remember that every child matters.

Learning more

As hard as it is, we need to acknowledge that this tragedy occurred and learn more about it so that it never happens again. I encourage you to explore several resources:

Cultural humility

Part of healing from this difficult history in Canada involves all of us developing our cultural humility – our ability to be respectful, self-aware, and lifelong learners when it comes to the experiences of others.

I encourage you to join me and participate in the First Nations Health Authority social media campaign to engage all of us in advancing cultural safety and humility in the health system. In my daily life, I strive to do my part to help create an environment in Northern Health where people feel safe from racism and discrimination. Make a pledge today and share it on social media. Together we can make a difference.

Victoria Carter

About Victoria Carter

Victoria works in Northern Health’s Aboriginal health program as the lead for engagement and integration. She is an adopted member of the Nisga’a nation and was given the name “Nox Aama Goot” which means “mother of good heart.” In her work she sees herself as an ally working together with Aboriginal people across the north to improve access to quality health care. She keeps herself well by honouring the mental, emotional, physical and spiritual aspects of her life through spending time with her friends and family, being in nature and working on her own personal growth.

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Bringing out the best: Breastfeeding, the World Health Organization and Quesnel

Mothers seated on couch breastfeeding infants.

Breastfeeding moms and babies at Quesnel Quintessence Breastfeeding Challenge in October 2015.

Living in one of northern B.C.’s smaller communities, you may not expect to be able to access globally-recognized, high quality training opportunities for free, right on your own doorstep. Yet this is exactly what a very successful initiative in Quesnel has been able to do.

The Baby Friendly Advisory Committee (BFAC) worked to successfully increase rates of initiation for breastfeeding at GR Baker Memorial Hospital in Quesnel. They recently widened their focus to increasing breastfeeding duration support in the community.

Benefits of breastfeeding

The benefits of breastfeeding exclusively for the first six months of life are well researched, with numerous health benefits for mother and baby. The goal is to increase the number of babies who are exclusively breastfed for the first six months of life (as recommended by Health Canada). Exclusive means that they receive nothing but breast milk until they are six months old (i.e., no solid foods, no water or breast milk substitutes) unless it is medically necessary. In order to meet this goal, the Baby Friendly Advisory Committee felt it was important to engage the community to support breastfeeding mothers. So, in November 2015, they offered a three day training using the World Health Organization breastfeeding course –a required course for every maternity nurse.

Breastfeeding course

The three day course was held at the Quesnel & District Child Development Centre –a child-friendly space. “The room had couches and tables and a kitchen for the participants – which included five breastfeeding moms as well as eight interested service providers,” says Bev Barr, Pregnancy Outreach Program Coordinator and BFAC co-chair, who was tasked with coordinating this initiative. “It was originally planned for April but we decided to postpone until November and commit to advertising and promotion.”

The group was determined to address potential barriers that are unique to breastfeeding moms. The final plan, in order to make the training accessible, included making the course free, choosing a location with free parking, making sure healthy lunches and refreshments were provided and – of most importance – ensuring child care arrangements for breastfeeding moms were in place. As a result, the final group included five breastfeeding moms among the attendees. “We all learned about breastfeeding while holding babies.”

“We had no idea how this would go,” says Bev, “and I was incredibly overwhelmed at how positive the response was, especially during that first day because of the high level of technical information. That day is very medically-focused, covering the physiology of breastfeeding, the nutritional composition of breast milk, and the health benefits to mother and baby. The next two days look at more practical issues and problem solving. The participants loved it all! At the end of the first day, they were talking about how much they hadn’t known and how much more they wanted to know.”

“What we have now is a well-informed and knowledgeable cohort who can support success in initiation and duration of exclusive breastfeeding in the community. Already we have heard three service providers say they are using the information in every visit. The course, in some ways, is bringing back networks of breastfeeding support that used to exist in many families and communities. It’s vital we have this capacity and knowledge in the community.”

Breastfeeding mother

Breastfeeding course participant Dawn Giesbrecht feeds baby Oliver.

Population health approach

It strikes me, as I reflect on my conversation with Bev, that this small, impactful project exemplifies some of the most important principles of Northern Health’s population health approach. The population health approach argues we need to get “upstream” on the river of diseases and causes of poor health in northern B.C. That is, addressing risk factors before they cause ill health is preferable to treating symptoms later on.

What are the principles shown by the BFAC project?

Do it right, not fast was obvious in the decision to wait and build readiness and interest in the audience group. Share what you have to offer and let the group do the work was evident in the willingness to offer a top-flight training opportunity and trust the group to rise to the occasion.

Understanding and addressing the specific barriers to participation that are unique to the group is also key. In this case, providing food, free parking, comfy chairs and a willingness to have babies in the room addressed a set of barriers that can exclude nursing mothers. Capitalizing on the passion and knowledge professionals can bring was also prominent in this work.

Partnership and collaboration were integral. In Quesnel, Northern Health was present in the room with professional expertise and insights and with concrete supports that addressed barriers to participation. At same time, Northern Health was sitting alongside its community members, learning with the community. Learning together is a way to build strong relationships and new connections that strengthen capacity to address issues of local importance.

Underscoring this, of course, is the passionate commitment of the working group who have dedicated years of service to supporting breastfeeding best practices in Quesnel. The BFAC is collaborative and includes representation from a number of individuals and groups. These torchbearers have lit a fire under the participants. The only request of participants was that they would commit to sharing their new knowledge and implement it in their own personal and professional circles. Many are now inspired and seeking additional training because of this opportunity.

The enthusiastic response of the participants to the training and their willingness to work with the new knowledge has given Quesnel a new and strong cadre of breastfeeding champions. The project also points the way to success. In a quiet and unassuming way, Northern Health professionals showed that partnership and population health are important parts of the good work in and by community to improve the health of northerners.


  • Do you have a breastfeeding story or experience to share? Tell us what breastfeeding means to you, your family, and your community by entering Northern Health’s World Breastfeeding Week contest before October 7!
  • This work was supported in part by an IMAGINE Community Grant. IMAGINE grants provide funding to community organizations, service agencies, First Nations bands and organizations, schools, municipalities, regional districts, not-for-profits, and other partners with projects that make northern communities healthier. We are looking for applications that will support our efforts to prevent chronic disease and injury, and improve overall well-being in our communities.
  • Read more IMAGINE Community Grant stories.
  • This article first appeared in Healthier You magazine. Find the original story in the Spring 2016 issue:

Theresa Healy

About Theresa Healy

Theresa is the regional manager for healthy community development with Northern Health’s population health team and is passionate about the capacity of individuals, families and communities across northern B.C. to be partners in health and wellness. As part of her own health and wellness plan, she has taken up running and, more recently, weight lifting. She is also a “new-bee” bee-keeper and a devoted new grandmother. Theresa is an avid historian, writer and researcher who also holds an adjunct appointment at UNBC that allows her to pursue her other passionate love – teaching.

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Get to know your community… Go for a Run!

20160920-holly-christian-runningMoving across the country can be a scary proposition, especially when all you know about your destination is what you’ve seen on TV. So when we found out we’d be moving to northern BC seven years ago, the first thing I did was go buy a map. Two moves and a lot of long road trips later, I’m happy to report that although it’s nothing like Vancouver, each dot on the map of our vast northern landscape has its own sense of community, unique personality, and way of life. One of the best ways I’ve found to plug into my surroundings has been to lace up and explore the trails, sign up for local races and events, and get outside!

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“Nature’s Staircase” – AKA Chetwynd Community Trail

Running (or walking) your local trails and roads gives you a great opportunity to meet people, see the town up close, and get to know the terrain. Whether it’s running up a mountain face, rock hopping across a river, or tackling nature’s stairs through the forest (see photo), literally every type of landscape can be found somewhere in northern BC.

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Holly and her friends after her first triathlon in Mackenzie

No matter how small the community, I’ve been pleasantly surprised to find that across the north there are groups and clubs for those interested being more active. Whether it’s running, triathlon, cycling, skiing, all are welcoming to the newbies and happy to offer tips to the inexperienced. I tried my first triathlon in Mackenzie, teamed up with friends and coworkers for the chilly Iceman in Prince George, ran my first half marathon up a mountain in Tumbler Ridge, and trained for my first marathon on the trails and country roads of the North Peace. Along the way I’ve made new friends, supported other reluctant runners to give it a shot, and continue to challenge myself to try new routes.

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Holly Christian and Melissa Aalhus tackle the Earth Hour 5K in Fort St. John

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Beatton Park snowshoe trails – Fort St. John

One thing to remember about exploring northern BC, is that you need to be prepared for anything. Weather can make or break a run, but if you prep in advance and wear the right gear, rain and snow can create an entirely new (dare I say pleasant) experience. After my phone battery froze on one cold winter (-25 degree) run, I entertained myself by listening to the crunching snow instead of music. Wildlife will also keep you on your toes. I have come face to face with a couple bears on my excursions around Mackenzie’s trails, and met a bull moose, fox and a couple of deer on some recent runs in Fort St. John. And nothing makes you run faster than finding a pile of fresh cougar scat on a trail, that’s for sure!

Whether running is your thing, or you’re just trying to get to know your community a bit better, I highly recommend checking out the local events in your area. If you aren’t feeling particularly athletic, there are also great opportunities to volunteer at events and races – and they’re always grateful for an extra set of hands!

I look forward to making many more runs across the north and exploring the northwest! My next adventure will be in the wilds of Hudson’s Hope for That Dam Run in September.

How can you plug into your community today? get inspired and maybe win a prize when you complete the Great Northern Scavenger Hunt!

Holly Christian

About Holly Christian

Holly Christian is a Regional Lead for Population Health. She has a passion for healthy living and health promotion and is a foodie at heart. Originally from Ontario, she has fully embraced northern living, but enjoys the warmth of the sun and the sound of the ocean. She swims, bikes and runs, and just completed her first marathon.

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